Kloucek, John Dale
Kloucek, John Dale is an individual health care provider with primary practice located at 4130 Sw 100Th Ave , Beaverton OR 97005. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Kloucek, John Dale can be contacted via phone (503) 626-0998.Contact Information
Primary practice address
4130 Sw 100Th Ave
Beaverton OR 97005
Phone: (503) 626-0998
Fax: (503) 626-0988
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | D6358 | Oregon |
Profile Details
| NPI number | 1972598357 |
|---|---|
| LBN Legal business name | Kloucek, John Dale |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 13th, 2005 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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